Fibroid Symptoms
Uterine fibroids can cause a great deal of pain and heavy bleeding, making it tough for women to carry on with their normal activities. Sometimes they can get so bad that they begin to affect her relationships and make it hard to enjoy time with her loved ones. Additionally, they can prevent her from being able to work and put her career or opportunities for advancement at risk.
The below listed symptoms are just some of the common symptoms fibroids in the uterus can cause, and this is not a comprehensive list. It may not include some fibroid-related symptoms that you may be experiencing. If you believe the pain, discomfort, or other unpleasant symptoms you are dealing with may be caused by fibroids, contact the Atlanta Fibroid Center today for guidance on getting the help you need.
Uterine fibroids are benign, or noncancerous, growths that develop in or around the uterus. Some cause no symptoms and are found during a routine pelvic exam or imaging test. When symptoms do occur, they can be easy to normalize because they may build over time. The FDA’s uterine fibroid overview explains that symptoms may include changes in menstruation, pelvic pressure, urinary symptoms, pain, and reproductive problems.
Not sure whether your symptoms fit the pattern? A symptom review cannot confirm fibroids, but it can help you prepare for a medical evaluation. Request an appointment with Atlanta Fibroid Center to discuss what you are experiencing and what evaluation may be appropriate.
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Major Uterine Fibroid Symptoms
Heavy menstrual bleeding
If fibroids are located close to the uterus lining, they can cause heavy and painful periods, often with blood clots, delayed periods, or spotting between cycles. You may need to double up on pads or use a cup to manage your flow and experience constant lower abdominal or back pain during or between periods. Everyone’s symptoms and intensity may vary, but these are common signs of uterine fibroids.
Heavy bleeding can develop gradually, so you may start to see it as normal even when it disrupts sleep, work, or daily activities. Keeping notes about your period length, how often you are having to change your feminine products, flooding, clots, and bleeding between periods can give your doctor useful context. The FDA recommends contacting a healthcare provider for heavy bleeding or bleeding between periods.
Pelvic pain
If you have pain below your belly button and above your legs, it counts as pelvic pain. It can be caused by a lot of things. It may be harmless evidence of your fertility, a simple digestive disorder, or a red flag that you may have fibroids, endometriosis, or another medical condition.
Fibroid-related pelvic pain or pressure may be felt across the pelvis or more strongly on one side. The pattern alone cannot identify the cause, so persistent, worsening, or severe pain deserves medical evaluation.
Back pain
There are multiple areas of the uterus where fibroids can grow. Intermural fibroids are located in the wall of the uterus, submucosal fibroids are located in the inside lining of the uterus, and subserosal fibroids are located in the outside lining of the uterus. Some fibroids can cause back pain that can be similar to sciatica or even cause pain to run down the leg.
Frequent urination
Some women diagnosed with uterine fibroids have pain and heavy menstrual bleeding. Other patients experience pressure on the bladder, frequent urination during periods and between periods, and frequent urination at night. Fibroids and frequent urination are frequent companions. It happens because uterine fibroids can press on the bladder, which results in an almost constant need to look for a bathroom, although the bladder is not even close to being full. For the same reason, women with uterine fibroids suffer from frequent urination at night, sometimes waking up multiple times each night.
Bladder pressure may also contribute to urgency, incomplete filling, or occasional urine leakage. Fibroids are not the only possible cause of urinary symptoms, so an evaluation should also consider issues such as urinary tract infection, diabetes, medication effects, and other pelvic conditions. For a closer look at this symptom, read Treatment for Fibroids Pressing on the Bladder.
Painful sex
How might uterine fibroids affect a woman’s sex life? Uterine fibroids can make sexual intercourse very painful. Women whose fibroids are growing in the upper portion of the uterus are more likely to have dyspareunia, which is pain during sex. There are several things you can do to help with pain during penetration, but the true reason for dyspareunia must be addressed to completely get rid of pain during sex.
Fibroids near the cervix may also contribute to deep pain during intercourse. However, pain during sex can have other causes, including adenomyosis, endometriosis, infection, pelvic floor problems, or vaginal dryness. Your doctor can help identify the cause rather than assuming fibroids are responsible. The related article How Do Fibroids Affect Sex and Intimacy? explores the impact on comfort and relationships in more detail.
Constipation
Large fibroids can cause symptoms such as heavy bleeding, the need to urinate frequently, constipation, bloating, and pain. Constipation and fibroids are frequent companions. Fibroids cause constipation directly and indirectly. The uterus lies directly in front of the distal end of the colon. Fibroids that develop in the back of the uterus can press on the colon from the outside, and in some cases, cause significant constipation.
Women that have fibroids that cause heavy menstrual bleeding can become anemic, which may require them to take iron supplements, which are known to cause constipation too.
Leg pain
If a fibroid is located on the back of the uterus, it is very close to the spinal column. If it becomes large enough, it can press on or pinch the nerves in that area, resulting in lower back pain. It can also cause sciatica as the fibroid presses against the sciatic nerve and sends pain down the back of the legs.
Enlarged abdomen
Numerous or large fibroids can enlarge the uterus enough to increase the size of the lower abdomen without a comparable increase in overall body weight. A woman may notice persistent fullness, tighter clothing, or an abdomen that resembles pregnancy. The Office on Women’s Health notes that very large fibroids can cause abdominal enlargement. Because pregnancy, digestive conditions, adenomyosis, and other problems can also change abdominal size, this symptom needs evaluation rather than self-diagnosis.
Enlarged uterus
Pregnancy isn’t the only potential reason for an enlarged uterus. Two of the most common causes of an enlarged uterus are uterine fibroids and adenomyosis. Uterine fibroids are very common tumors affecting as many as 8 in 10 women by the age of 50 (especially African American women). Adenomyosis occurs when the tissue that normally lines the uterus (endometrial tissue) begins to build up in the muscular layer of the uterus, which causes it to become larger.
Infertility
Fibroids can affect your fertility. Fibroids that change the shape of your cervix can affect the number of sperm able to enter the uterus. Fibroids that weaken the lining of the uterine cavity or decrease the blood supply to a growing embryo can cause a miscarriage. Fertility can also be affected by scars from a myomectomy (fibroid surgery).
Depending on their location, some fibroids may also distort the uterine cavity or place pressure near a fallopian tube. Still, many people with fibroids become pregnant, and fertility problems can have many causes. The National Institute of Child Health and Human Development lists infertility and pregnancy complications among possible fibroid-related problems.
Anemia
Heavy blood loss due to fibroids can cause anemia. Anemia can lead to shortness of breath, fatigue, and serious health problems. Anemia can be treated by addressing the reason causing the condition. If anemia is caused by uterine fibroids, they need to be treated.
Other possible signs of iron-deficiency anemia include dizziness, lightheadedness, headaches, a fast heartbeat, pale skin, and cravings for ice or nonfood substances, a symptom called pica. Your doctor may use a complete blood count and iron testing to check for anemia. The Atlanta Fibroid Center article Fibroids and Anemia: What Should Be Treated First? provides additional background.
How Fibroids Are Evaluated
Symptoms can point to a problem, but they cannot confirm fibroids because several gynecologic, urinary, and digestive conditions can look similar. Evaluation may include a medical history, pelvic exam, blood tests for anemia, and imaging. Ultrasound is commonly used as the initial imaging test because most doctor’s offices already have this technology in their office, and it is easy to administer.
MRI imaging provides much more detail when a doctor needs to better identify the location and size of the fibroids or plan treatment.
What to Do If You Have Possible Fibroid Symptoms
A thorough evaluation can determine whether fibroids, adenomyosis, endometriosis, a urinary condition, or another cause is responsible. If fibroids are confirmed, the right next step depends on the severity of your symptoms, the fibroids’ size and location, your health history, and your goals for pregnancy and uterus preservation.
Some people with mild or no symptoms may only need monitoring. Other patients may discuss medication, surgery, or an interventional treatment. Uterine fibroid embolization (UFE) is a minimally invasive option that reduces blood flow to fibroids so they shrink over time. A consultation and imaging review are needed to discuss candidacy, benefits, risks, and alternatives.
If heavy bleeding, pelvic pressure, bladder symptoms, or pain are affecting your life, schedule a consultation with Atlanta Fibroid Center to review your symptoms and learn which next steps may fit your situation.
Frequently Asked Questions
Can small fibroids cause noticeable symptoms?
Yes. Fibroid size is only one factor. A small fibroid near the uterine lining may contribute to bleeding, while a larger fibroid elsewhere may cause pressure symptoms or no symptoms at all.
Can fibroid symptoms change during the menstrual cycle?
Yes. Bleeding, cramping, and bloating may be more noticeable around your period, while pressure-related symptoms such as frequent urination or constipation may occur throughout the month.
Do fibroid symptoms always get worse over time?
No. Symptoms can stay stable, worsen, improve, or change as fibroids and hormone levels change. A new pattern, symptoms after menopause, or symptoms that interfere with daily life should be evaluated.
Does every person diagnosed with fibroids need treatment?
No. Fibroids that cause no symptoms may only need monitoring. Treatment decisions depend on symptoms, fibroid size and location, pregnancy goals, overall health, and personal preferences.
